Nausea and Vomiting During Pregnancy

Nausea and vomiting is a normal part of pregnancy, but there are steps you can take to feel better.

If you are pregnant and have nausea and vomiting, you’re not alone. Over half of all pregnant women suffer from this common ailment, sometimes called ‘NVP’.

The symptoms can be very unpleasant and can interfere with your daily routine. The good news is that nausea and vomiting isn’t usually harmful to you or your unborn child.

And, there are many ways of easing your nausea and vomiting. Your doctor, nurse or midwife can help you find the right solution for a comfortable and healthy pregnancy.

‘Nausea and vomiting of pregnancy’ is also called ‘morning sickness’ — even though it can happen at any time of the day.

What causes nausea and vomiting?

No one knows exactly why women have nausea and vomiting when they are pregnant. It’s probably due to all of the changes taking place in your body, such as high levels of hormones in your blood.

However, it could be due to an illness or other medical problem. Not all nausea and vomiting is related to pregnancy.

How long will these symptoms last?

Nausea and vomiting usually starts around the sixth week of pregnancy and stops around the 12th week. However, you may still have queasiness after that, often up until your 20th week. Some women will have nausea and vomiting for longer, maybe even until the end of pregnancy.

Should I be worried?

Nausea and vomiting isn’t usually harmful for pregnant women and their babies. For most women, nausea and vomiting doesn’t last all day and there are times when they feel hungry and can keep food down.

However, in severe cases you may not be getting the nutrients and fluids that you and your baby need. Speak with your health-care provider if you are so sick that you miss meals day after day.

What if I just can’t keep anything down?

About one per cent of pregnant women in Canada have ‘hyperemesis gravidarum’. This is when you are so sick that the lack of fluids and nutrients being taken in may be dangerous for you and your baby.

The biggest worry is dehydration. If you don’t have to go pee very often or have dark yellow urine, and you cannot drink enough liquid to correct this condition, call your health-care provider. You should also get help if you are so sick that you are losing weight rapidly.

Nausea and vomiting can be difficult to control; the sooner you are diagnosed and get treatment, the more likely you will be to avoid severe symptoms.

Helpful tips to control nausea and vomiting:

What you eat, and when

In the morning, eat a few crackers and rest for 15 minutes before getting up.

Get up slowly and do not lie down right after eating.

Eat small meals or snacks often so your stomach does not become empty (for example, every two hours). Try not to skip meals.

Eat what you feel like and eat when you are hungry, though you may want to avoid cooking or eating spicy, fatty or fried foods because of the smell.

If cooking smells bother you, open windows and turn on the stove fan. If possible, ask someone else to cook. Eat cold food instead of hot, as it may not smell as strongly.

Sniffing lemons or ginger can sometimes help an upset stomach.

Eating salty potato chips can help settle the stomach enough to eat a meal.

Tips to get enough fluids

Sip small amounts of fluid often during the day.

Avoid drinking fluids during, just before or immediately after a meal.

Food ideas to help relieve nausea

Salty: Chips, pretzels

Tart/sweet: Pickles, lemonade

Earthy: Brown rice, mushroom soup, peanut butter

Crunchy: Celery sticks, apple slices, nuts

Bland: Mashed potatoes, gelatin, broth

Soft: Bread, noodles

Sweet: Cake, sugary cereals

Fruity: Watermelon, fruity popsicles

Liquid: Juice, seltzer, sparkling water, ginger ale

Dry: Crackers

Getting enough rest

Get plenty of rest, and try napping during the day; nausea tends to worsen when you are tired. Many women find they need more sleep in the first three months of pregnancy.

You may need to take some time off work or make other arrangements for household chores and childcare.

Get help and support from friends and family.

Lifestyle strategies

Get plenty of fresh air and avoid warm places as feeling hot can add to nausea.

Try acupressure wrist bands.

Acupuncture can help some women. Speak to your health-care professional first and look for an experienced and licensed acupuncturist.

Try ginger, an alternative remedy thought to settle the stomach. Doses of up to

250 mg four times a day appear to be safe.

If multivitamins make your nausea worse, try taking your prenatal vitamins with food or just before bed. There are also pills that are smaller or have lower iron content. If you can’t take any multivitamin, take a folic acid pill (0.4 to 1.0 mg) alone until you feel better.

Is there medication that can help?

Many women want to avoid taking medicine when they are pregnant. However, changing your diet and daily routine might not be enough to relieve your symptoms. You shouldn’t feel guilty about wanting to feel better, and your health-care provider can prescribe medication to help reduce your nausea and vomiting.

In Canada, Diclectin® is the only medication approved for the treatment of nausea and vomiting in pregnancy. It contains doxylamine (an antihistamine) and pyridoxine (vitamin B6). Its safety and effectiveness for pregnant women is recognized by Health Canada and studies have shown no evidence that harmful effects are experienced by babies.

If this medication does not ease your symptoms, speak with your health-care professional to discuss other solutions.

Are natural products safe?

People often assume that ‘natural’ products or remedies are safer than prescription medications. However, many of these natural or herbal products have not been clinically tested to evaluate their safety and effectiveness. Even fewer products have been properly tested during pregnancy. Ask your health-care provider before taking any herbal remedies.

Should I worry if I don’t have nausea and vomiting?

No. Every pregnancy is unique: the severity of nausea and vomiting you experience may be different from other women, and may even be different each time you are pregnant.

Further resources:

For advice on nausea and vomiting in pregnancy, you can call the Motherisk program of the Hospital for Sick Children in Toronto toll-free at1-800-436-8477. For information on the safety and risks of medications during pregnancy and breastfeeding, call the Motherisk program at 1-877-439-2744 or visit www.motherisk.org.

Other resources from the Society of Obstetricians and Gynaecologists of Canada: